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Cancer survival: impact on cancer control policy in England

Summary of the impact

The core target in the government's national strategy for cancer control in England is to `save 5,000 lives a year by 2015'. This target was taken directly from research done by LSHTM showing that 10,000 cancer-related deaths per annum would be avoidable if five-year relative survival were as high as the highest levels observed in Europe. Current government strategy is entirely focused around `halving the gap' in avoidable premature cancer deaths identified in this research, which also forms the basis for England's National Awareness and Early Diagnosis Initiative.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Improving the health and wellbeing of cancer survivors

Summary of the impact

Improvements in therapy have increased the 5-year survival rate for a number of cancers, leading to a new focus on promoting the health and wellbeing of cancer survivors. In the UK alone, over 500,000 people have physical or psychological consequences associated with cancer or its treatment.

Research at the University of Surrey has led to the development of self-management interventions for cancer survivors, demonstrating that active patient involvement leads to significant health and wellbeing benefits. These studies have driven national and international practice policy in the management of the consequences of cancer and its treatment.

Submitting Institution

University of Surrey

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Meeting the information needs of men with penile cancer

Summary of the impact

Men with penile cancer often feel very isolated as they are reluctant to talk to others about their condition, and as it is so rare, they do not encounter others who have experienced it. Branney and colleagues' work has produced a resource, available through the Health Talk Online website, for men and their families: http://www.healthtalkonline.org/Cancer/Penile_Cancer.

Men with penile cancer are routinely signposted to this resource. An exhibition of the project's findings has helped to raise awareness of the condition in the general public. By increasing patient information support, clinician insight and men's awareness of the condition, this research has improved the quality of life of men with penile cancer.

Submitting Institution

Leeds Metropolitan University

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Re-assessment of Cancer risk in Barrett’s oesophagus.

Summary of the impact

Research within the Northern Ireland Barrett's oesophagus Register demonstrated that cancer risk in this disease was substantially lower than previously thought. It identified clinico-pathological characteristics and potential biomarkers that allow Barrett's patients to be stratified into those with higher and lower cancer risk. This research has influenced recommendations from Gastroenterological Associations in the UK and USA and resulted in altered clinical practice nationally and internationally, in which costly routine endoscopic surveillance is now targeted to Barrett's oesophagus patients with the highest cancer risk.

Submitting Institution

Queen's University Belfast

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Case Study 9. Changing cancer services and improving patient outcomes in the UK

Summary of the impact

Research in Leeds showed, conclusively for the first time, improved outcomes for cancer patients managed in multidisciplinary specialised cancer care teams. Our research and systemic overview provided the evidence for a new government policy to reconfigure cancer care services into Cancer Networks, Centres and Units. This required radical evidence-based changes including centralisation of many cancer surgical services. A rigorous implementation plan based on research evidence, was initiated under Leeds leadership and sustained in subsequent government policies. It changed clinical guidelines and professional standards, altered practice for all UK cancer patients and contributed to improved cancer survival.

Submitting Institution

University of Leeds

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Oncology and Carcinogenesis, Public Health and Health Services

Evidence-based primary care interventions to improve health benefits in cancer care

Summary of the impact

Bangor University staff (Neal & Wilkinson) are core members of a collaboration whose research since 2003 has had significant policy relevance and impact in the field of primary care oncology. Impact has been made in three areas:

  • The role of primary care in the earlier diagnosis of symptomatic cancer; for example by determining the predictive value of symptoms and translating this into Risk Assessment Tools for clinical practice
  • The contribution of primary care to cancer follow-up and the management of survivorship; for example by changing practice by illuminating poor care in prostate cancer
  • Empowering patients through communication of new cancer-related science in primary care; for example by developing core messages for use in communication about HPV.

Submitting Institution

Bangor University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Introduction of a national colorectal cancer screening programme

Summary of the impact

Research undertaken at the University of Sheffield in 2005 to evaluate the cost-effectiveness and resource implications of potential screening programmes for colorectal cancer informed the decision to launch a national colorectal cancer screening programme in England. Upon their 60th/61st birthday, all individuals in England are now invited to participate in biennial bowel cancer screening using faecal occult blood testing (FOBT) until the age of 74. The programme identifies individuals with less advanced colorectal cancer and there is emerging evidence that it has led to an overall improvement in prognosis. Projections suggest that the programme is on course to reduce colorectal cancer deaths by 16%.

Amongst others, follow-on research includes an options appraisal of screening in Ireland that has informed national policy and a re-appraisal of colorectal screening options following publication of a pivotal trial of flexible sigmoidoscopy (FSIG) screening for NHS Cancer Screening Programmes.

Submitting Institution

University of Sheffield

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Improving care and support for patients and families throughout the cancer trajectory. (ICS-03)

Summary of the impact

Research by our group at the University of Manchester has impacted directly on policy addressing inequities in access to treatment for older women with breast cancer, affecting treatment for 10,060 older breast cancer sufferers in England each year. Our research has led to improvements in pre-operative nutrition and screening for malnutrition for nearly 100,000 patients in Greater Manchester. We have contributed directly to international guidelines on post-treatment follow up for breast cancer and management of cough in lung cancer. We have also contributed to development of national vocational rehabilitation, employer support and benefits advisors for cancer survivors, affecting 700,000 survivors across the UK. Our work has led to implementation of family carer support needs assessment in UK hospice services, to date supporting some 4,500 carers per year with wider roll out imminent.

Submitting Institution

University of Manchester

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Use of aspirin and high dietary fibre to prevent and reduce deaths from bowel and other cancers, influencing global policy on cancer prevention and major public health campaigns (‘five-a-day’)

Summary of the impact

Thousands of people across the world with a genetic predisposition (HNPCC) to bowel cancer, together with the population at large, have benefited from research on aspirin and dietary fibre undertaken at the University of Bristol since 1993. Clinical trials involving the Bristol group show that the incidence of bowel cancer has fallen in HNPCC patients who take aspirin. Moreover, aspirin use after diagnosis of bowel cancer has reduced colorectal cancer mortality. Furthermore, a high fibre diet also lowers the risk of bowel cancer. These studies led to national public health initiatives (such as the `five-a-day' campaign) that have been instrumental in increasing public awareness of the importance of aspirin and dietary fibre in reducing the risk of bowel cancer, and in establishing international guidelines on dietary advice.

Submitting Institution

University of Bristol

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Oncology and Carcinogenesis

Case study 5. New systems for patient self-reporting improve care and quality of life for cancer patients

Summary of the impact

Researchers at the University of Leeds have designed and developed new approaches and technologies for cancer patients to self-assess their symptoms and quality of life. The work focused on electronic methods for collecting patient-reported outcome measures (PROMs), developing PROMs for neglected areas of patient care, and running trials of these techniques. These approaches produced sizeable patient benefits including improved symptom control and better quality-of-life. These findings have influenced clinical guidelines in the UK and Canada, NHS policy and the endorsement of PROMs in the Health and Social Care Act (2012). Electronic PROMs systems based on the Leeds research have been implemented locally, nationally and internationally, making measurable improvements to patient welfare and health, such as a reported significant increase in completion of chemotherapy treatment.

Submitting Institution

University of Leeds

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services

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